The presence of intestinal fungi and chronic liver damage increase the risk of death for people suffering from liver disease caused by excessive consumption of alcohol, a new research has suggested. The progression of alcohol related liver disease can be retarded with the help of anti-fungal compounds like amphotericin B. However, there are no treatments to decrease the severity of alcohol related liver disease.
Senior author Bernd Schnabl from the University of California San Diego that the progression of alcohol related liver disease may be reduced by modifying the balance of fungi that thrive within the patients’ intestine.
The researchers found that mice that had chronic alcohol exposure had fungi that lived within their intestines. Chronic inflammation is known to destroy liver cells and ultimately leads to alcoholic liver disease. They also found that they could defend the mice from alcoholic liver disease by giving them anti-fungal compound amphotericin B as part of their treatment.
After their treatment with amphotericin B, the mice with alcohol related liver disease were found to have lesser amounts of liver injury and fat accumulation, as compared to mice which were untreated. The results were determined by measuring the plasma levels of a liver enzyme called the alanine aminotransferase and liver triglycerides. The alanine aminotransferase was found to have reduced by approximately 55% and triglycerides by approximately 21%.
For the study the mice were given a type of oral amphotericin B that is not taken into the blood steam. In humans, however, the use of oral amphotericin B is not approved by the FDA. Intravenous amphotericin B is approved by the FDA to cure severe fungal infections and it is known to cause side effects such as pain in the bones, joints, stomach and muscles and cause shortness of breath.
The stool of eight people with good heath was compared with that of 20 patients with chronic alcohol abuse and in different stages of liver disease. The results revealed that there was a richer and better range of fungi thriving in the intestines of the healthy people as compared to those of the patients with alcoholic liver disease.
Additionally, the researchers also found a relationship between the levels of fungi and severity of the liver disease in a separate group of 27 patients with liver disease caused by alcohol. After a period of 5 years, 77 per cent of the patients who had low fungi in their intestines survived, compared to 36 percent who survived in the group with high fungi levels.
The efficacy of the treatment with amphotericin B in mice is motivating the researchers to test amphotericin B IN patients suffering from alcohol related liver disease, according to Schnabl. The journal of Clinical Investigation has published the study.